S3001
Invited Speaker
ESTRO 2026
5319 Harnessing metabolic insights for clinical translation Marianne Koritzinsky Princess Margaret Cancer Centre, University Health Network, Toronto, Canada There is profound heterogeneity in how tumors generate energy, manage oxidative stress, and interact with their microenvironment. Metabolic deregulation and adaptation are increasingly recognized as key determinants of treatment response, where oxygen availability, redox balance, and nutrient utilization influence radiation response. Increased understanding of deregulation of metabolism in cancer has also revealed vulnerabilities that can be leveraged with an acceptable therapeutic index. This talk will explore how emerging metabolic insights can be leveraged for clinical translation, bridging mechanistic understanding with actionable therapeutic strategies. 5320 Toward consensus: Harmonising radiotherapy practice across Europe and beyond Alina Emiliana Sturdza 1 , Gabriella Macchia 2 , Giorgia Garganese 3 1 Radiation Oncology, Medical University of Vienna, Vienna, Austria. 2 Radiation Oncology, Responsible Research Hospital, Campobasso, Italy. 3 Gynaecology, Gemelli Women’s Health Center for Digital and Personalized Medicine, Dipartimento Scienze della Vita e Sanit`a Pubblica, Rome, Italy A recently published international survey conducted among radiation oncologists with recognized expertise in vulvar cancer, aimed at assessing the real-world implementation of the current ESGO guidelines. The survey revealed a substantial variability in clinical practice, not only in terms of guideline adherence, but also in the interpretation of recommendations and in the management of several clinically relevant scenarios that are not completely addressed by existing guidelines and are poorly supported by the available literature. These findings highlight the presence of persistent areas of uncertainty in daily clinical practice, where treatment decisions are often driven by individual experience rather than by robust evidence. The authors of the survey believe that a structured, expert- driven consensus process is both timely and necessary to critically appraise the evidence, integrate multidisciplinary perspectives, and develop consensus- based recommendations to better support clinical decision-making. The detailed steps and timeline for this process will be presented.
brachytherapy, analgesia optimisation and molecular profile based personalisation of treatment; application of 3D printing and automation/AI in clinical workflows.
5317 Understanding and modulating tumour metabolism to enhance radiotherapy response Johann Matschke University Hospital Essen, Institute for Cell Biology (Cancer Research), Essen, Germany Radiotherapy induces a wide range of adaptive responses in tumour cells that extend beyond DNA damage processing and include substantial metabolic reprogramming. These changes affect mitochondrial function, redox homeostasis, substrate utilisation, and cellular stress tolerance, thereby influencing how tumour cells respond to irradiation. Increasing evidence suggests that such metabolic adaptations are not merely consequences of treatment, but important components of radiation response biology that may shape survival under genotoxic stress and contribute to radioresistance. This presentation will focus on the biological basis of metabolic responses to radiotherapy and on the question of how irradiation reshapes tumour cell metabolism over time. Particular attention will be given to dynamic changes in mitochondrial activity, oxidative metabolism, redox balance, and metabolic plasticity as part of the cellular adaptation to radiation- induced stress. The aim is to highlight metabolism as a functional layer of radiation response that interacts with broader stress response programmes in tumour cells. The talk will further address how adaptive metabolic states may help explain heterogeneity in radiation response and treatment resistance across tumour models. By considering metabolism as a dynamic rather than static feature of tumour biology, the presentation will outline a mechanistic framework for understanding how irradiated tumour cells adapt to stress and how these adaptive processes may create distinct biological dependencies. Overall, the presentation will provide a preclinical and mechanistic perspective on the role of tumour metabolism in radiotherapy response. By integrating concepts of metabolic adaptation, stress tolerance, and targetable vulnerability, it aims to outline a framework for understanding how modulation of tumour metabolism may enhance radiosensitivity and support the development of more effective radiotherapeutic strategies.
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